Background on Ghana

   Ghana, situated on the west coast of Africa, is one of the least developed countries. The average GNP per capita is just $390 a year; roughly half the population lives on one dollar a day or less.

   The total population of Ghana in 2000 was 20.2 million. Currently, the country’s population is growing by 2.5 per cent per year. At the same time the total fertility rate has declined from 5.5 children per women in 1995 to 4.5 by 2000.

   Over the same period of time (1993 to 2000) the infant mortality rate declined from 66 deaths per 1,000 live births to 56 deaths per 1,000 live births. The maternal mortality rate has been estimated at 214 per 100,000 live births. As a national average, 40 per cent of all births are now attended by a trained health professional.

   Still, there is a distinct North-South divide in the country. The impoverished northern part of the country suffers from much higher rates of infant and maternal mortality, registers a total fertility rate nearly twice that of the nation as a whole and has fewer well equipped health facilities compared to the populous southern region. Maternal mortality in the north varies from 330 to 500 per 100,000 live births. Total fertility rates are close to 7 children per woman and only 9 per cent of all deliveries take place in a health facility with trained personnel (compared to three-quarters in the Greater Accra region). Literacy rates are only half the national average: 23 per cent compared to 48 per cent.

   As in the rest of Africa, young people between the ages of 10 and 24 comprise more than one-third of the total population of the country. By 2025, young people will number 12 million. Teenage pregnancies are a continuing problem for the Government. Girls in the 15-24 age group account for approximately one-third of all births every year. These high rates are a result of early marriage, sexually active youth, lack of knowledge of reproductive health and lack of access to youth friendly reproductive health information and services. Adolescent child-bearing is twice as high in rural areas as in cities.

   As of December 1999, close to 31,000 HIV positive cases had been identified. Just under 5 per cent of the adult population is infected. However, by 2005, UNAIDS estimates that 1.2 million people will be infected with the virus that causes AIDS, unless prevention strategies begin to work. The Government has set up an inter-ministerial commission, under the chairmanship of the President, to coordinate the national response to the AIDS crisis. A national policy on HIV/AIDS has been adopted and a strategic plan of action has been approved.

   Ghana ratified the Convention on the Elimination of all Forms of Discrimination Against Women in 1986. Gender issues have received considerable attention as a result of national efforts to implement the ICPD Programme of Action and the Platform for Action of the Fourth World Conference on Women (known also as the Beijing Platform of Action). Under these initiatives, certain harmful practices, such as female genital mutilation, have been outlawed. The Parliament passed the Children’s Bill, which raised the minimum age at marriage from 16 to 18 years. The Government has adopted Affirmative Action Policy Guidelines which call for an increase to 40 per cent the representation of women in key positions in public service and in national executive or policy-making institutions.

   Ghana has adopted the ICPD concept of reproductive health and has formulated policies, standards and protocols to guide the delivery of reproductive health services. Health facilities at the primary health care level offer reproductive health, including family planning, in an integrated manner through 1,050 public sector health centers and over 12,753 community outreach sites. Ten regional and 110 district hospitals are designated as main referral centers for complicated pregnancies. In addition, quality reproductive health services are provided through 1,039 private facilities.